Since the dawn of antibiotics, there has been antibiotic resistance. Until about 20 years ago, this threat remained muted because there were plenty of new antibiotics in the pipeline to replace those that had stopped working.

Today, there are fewer than 50 antimicrobials in the pipeline, according to Pew Charitable Trusts. Resistant bacteria, meanwhile, are slowly but surely spreading across the planet. If nothing changes, British think tank the Wellcome Trust, estimates that 10 million people will die annually from a resistant microbe by 2050.

Getting the public to understand and pay attention, however, remains a challenge for health journalists.

“I liken it to climate change in that the individual actions that you do or that any of us do, don’t necessarily connect to being potentially cataclysmic,” said Matt Richtel, a science and investigative reporter for The New York Times. Richtel has been a lead author in the paper’s ongoing series “Deadly Germs, Lost Cures,” on antibiotic resistant infections, the causes and possible solutions.

Richtel decided to take on the task of trying to get Americans to understand the growing threat because he needed something “meaty” to work on after finishing a series for the paper in 2018 about obesity and because he had written a book about the immune system.

The Times gave him several months to explore the topic and develop the series’ concept – there is a disconnect between Americans’ understanding of antibiotic resistance and the relevance of this threat to their personal lives. Then he dove deep, trying to find stories about antibiotic resistant infections that people would share.

“For this to be powerful, effective story telling, we had to find stories that make it impossible for the reader to turn away,” Richtel said.

It was the hardest assignment of his career. Hospitals and nursing homes don’t have to report publicly on antibiotic resistance. They do have to tell the Centers for Disease Control and Prevention about it, but the CDC doesn’t have to say which specific hospitals and nursing homes are experiencing an outbreak of a resistant bug. The same is true in many other countries. Hospitals don’t have to tell the public if there is an outbreak. Doctors didn’t want to talk either, nor did many patients.

“This is the hardest journalism that I have done, by far,” said Richtel, who won a Pulitzer Prize in 2010 for a series on distracted driving.

Richtel talks more about the grunt work involved in finding sources for his story in this new How I Did It piece. The upshot is that he spent lots and lots of time on the phone and used social media to find people. He enlisted the support of his Times colleagues as well.

“I want to give props to all the journalists that came before me, who have been trying to focus the public on this and say: ‘Look, this is happening. This is a threat.’, but the entrenched nature of current economic interests … and the complexity of explaining this,” has made it hard to break through, he said.

Richtel is hoping that changes with the series, which began in April with “A Mysterious Infection, Spanning the Globe in the Climate of Secrecy” about the rapid spread of the resistant fungus Candida auris and the many people globally who have been infected.

As of the end of July, the Times had published 11 stories in the series, which includes articles about antibiotic use in animal food farming and agriculture. Richtel said there are many more stories to come that he believes will “shake” the health care sector and the public.

• • Learn more about the series and how Richtel is doing his work here.
  • See AHCJ’s tipsheet on covering antibiotic resistance here.
  • Dentists urged to reduce prescriptions of pre-treatment antibiotics
  • World Antimicrobial Resistance Congress, Nov. 7 & 8, 2019, Washington, D.C.
  • U.S. Antibiotic Awareness Week, Nov. 18-24, 2019